The Multi-Site Implementation Evaluation of Tribal Home Visiting (MUSE) will articulate and test a conceptual model of how implementation and cultural and contextual adaptations, enhancements, and supplements (AES) of home visiting programs relate to quality of services and outcomes in tribal communities. The MUSE Team of James Bell Associates, Inc. (JBA) and Centers for American Indian and Alaska Native Health (CAIANH) at the University of Colorado Anschutz Medical Campus will engage tribal grantees, tribal and organizational leadership, and subject matter experts to create an innovative yet feasible multi-site implementation evaluation of Tribal Home Visiting. The MUSE conceptual model along with priority evaluation questions, to be refined in partnership with stakeholders, builds on the Mother Infant Home Visiting Program Evaluation (MIHOPE) conceptual model for implementation. This adaptation of the MIHOPE model highlights unique cultural and contextual inputs, outputs, and outcomes, and communicates that culture is critical rather than peripheral. MUSE will examine how cultural and contextual adaptations, enhancements, and supplements of tribal home visiting programs relate to quality of services and outcomes in tribal communities. Mixed-method design, measurement, analysis and data collection execution plans will be developed and implemented with full participation from grantees. The MUSE Team has developed an initial menu of data collection methods and measures that correspond to this conceptual model. This wide array of potential methods (e.g., qualitative interviews, staff surveys, home visitor activity logs, etc.) will be reviewed and assessed for feasibility, cost, and appropriateness in partnership with MUSE stakeholders, and existing data currently collected by grantees and reported to ACF in the aggregate will be used whenever possible.